GW1-2021-00689_Well Construction - GW1_20210203

"ELL CONSTRL'C110a RECORD F.r b.nsr l ,(ONI)
Pr.G,rn.::rl Fs ."I rrr sinrJ,'.•.:nrdupk w AI.
I.16 d1[infractor lnfurmanon:
IL HATER TANGS
Brian Swing Fxo\I I(, 1 m'a xrrnnN
A'.IIlb,xnnrr N.ulK fl. ? ft.
9240-B 11. It.
N( to d't,:nl defer c rm:n.Iln• r,iimcr 15.Ol TER CASING ifor nuNi-avgll wrllo OR LINER IR anPRca6le)
FROM TO WYNFTFU T11r('FN it \I\TTRteI
SAEDACCO Inc 0 If. 11' p, 1.5• eu. - NA Steel
I If a I n N.olu la INNER ASIN( OR 71 RING iroilemal c6wed4wP)
FROM To DINIFTFxm _�IN(A\FSS _r N\TFRIq
s %Wil(ontiveDon PermitM I0300399; 70002483 ft.
rr.",., lgrcJart.••. 17.V'R[EN�__
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1laterSupph %%e1L FROM ITT ptdNrTrx IUT ws rorT.NrNc N\TrxI N.
11' A. 19' lit. r14—Iii NA Steel
119gwulnual 1141unicifNJ:TNd+h:
I1[xodemul IHc:ldng:(fnolnlr.Supptu ; IRcsidcnrud W:ncr 4ufq,h I.Llxicl
Lnition;d(onuucrcial IR.idental R'atcr Supph lslurcd, IT.GRO(T
FROM I F_fl MNTFRI\I_ F%fP1.\(FNFNT NFTIIOUJ.YrIOI'Nr
❑Ifrl^'limn ff. -_
NonAl6afar Supph%Pell: I
:�Sfomtomn6 (I. ff❑Raman __
Injection N'rll: — ff. D.
f l A41ofet Rechar" II(woond.ater Rancdlation 11 ANDIiR 'ELPA[KliFaMleablel
YRIIM Itl rl\TrRl%l .MPI.NFMrNTN 1111011
l Aquifer SlomFc:ud Romcn fltialllllA flamer ft. b, 1
aglufer Test ;15urm v alcr rh:una_c --
❑F.cpcnnlcnlal Inhnnlov, ❑Sohsldcrl Conml
M.DRII.UNG IAGIA11arY addiliadahren Rwcewnl
❑Garotfemui I(lased Larpl ❑Ifacet gino
- r0 nrc(ulPnnNn.er,lur4.,a-1m-F -tr,MI
74otfemul Illeatrne(uulur_-Rduol X(AbIa I CNFIIIIIII ulll 921 Rnuadsl 0 n. 19' n.
11. It.
4.Dale%Yell(,)('utlylifp:d: 1/l9/:!1 Ild1 Iffo ll
.__.... IL It.
SA.A1dl l4acation: 11. 11.
Remediat ion ?fana�c ament Sc m•ice Company 11, ft, {F..,W,O l\'s„cr N:n F.I0.1, IR=nL,rpirahk` ff, fl.
2690 Shenandoah .'.ve., C4ar'.otte, NC, 28205 •-- fr. �— -- _(o.t--- -
Plu;gal M6lress.Cn,.pest 7T
21.REMAR-i—_
KS
Mecklenburg I. 12710204 Temporary injection po:'nt through UPT tooling
Cane 1'n:d 1,41gdulwn No IPINI
5b.Latitude and I.onpitutle in deEr revatioulm.secomh or decimal dogmv,.: 22.('eitifxation:
;'I ucll find .".Is Inlc , ,dhI:..d1
35.210933 N -80.801087 �� Brian Ewing 1/27/2021
- �. \ elJutlr.of('<nlfsd Wall Flvnngor Dale
6.I.(af)file well(%): �Prrmanfut or %Tengwlran _ H. , . r ^ur" ,,, ,nr o,. ,1•„ .. . ..•,_,, .,,r::,u.
IN this a repair to an eaistingw ell: -1n nr Kso , •., ,.... .,,:r•,:.!,., ;•' .. ". ,•,
III- nu�.w rO �.m....... ....
,u.. _, ,,.,,:,x.... ,,,,.0 ....•.n;n„n�..., 23.Site di.Mram or additional well defAils:
Slrl Ilan use the hod. of this Ittfeti to prm,de:Rldllluu:d ,Ill site III I, avil
R.Number of well,alnslructed: 1 eousini delalls. You nos :dw:madl addobntcd peers it io cssan
,.,,.F.", ,„a.,..,.,. ,I
11.11.1 St BNIII IAL INS II'(IIONS
9.Total well dcplh bf6m land urfacc 19 (ft.) 24a For All %fell,: Subnal (his lint within al L." of c(wnplctrnt of licit
I,I —A!". ,, .r , ,..,ny.',- ­l :awl .onnmellnnm Oe helfantry!
III.Static water tort lxRlw mp o!cAunp Ift.) Dir life of ll Ater Rnon Teri.Information PnlensjnE l nil.
1,".,,:I, .l .•.,,,,.I.,.., ,.. . 1617 MAN Service(rater.RAlrith.NC 276m)-lull
11.Borehole diameter.1,5r (in.) 24h. For In Wlon %ell%ONIA: In addition to seldaig Tic form to du ;kfdit s In
14a aMwe. also submil a cups of this fool afllon ;n Ikos of cuurylclwm of waR
12.Nell OlnrleuCtio,MIThad: DRIVEN cunslmtlunl In Ile follcvune
Pis Isitn of%i l lrr Remmor .I:ndc•rground Injection[untrol Program.
FOR U ATER St PPl.1 \AFLLS ONl.1: 16,16 Nail Seel ice('four.Raleigh.N( 27640)-1636
UA.1 idd(L'Rm) Nlethod of ITN: 2U.For 11-Ater Supph AL Injection Rrllc
_. . - Also .Minna one Lops of this font allnll ;(I do%sif cunlphlkln of
IJb.Disinfection npe: :Amount: well cnustn¢non to the county he llh defNlmlenl of the coons niter,
Lonsarimcd
f.,m10\1-I Nr•n111�mhwl lATumrcm,•Ifit,mvuam nd N,nnr lN.wun:. LhI^lli of\\.o09oyou(e R:,nd slgust v:(I